Shingles is a disease caused by the varicella-zoster virus, which is the same virus that causes chickenpox. After chickenpox illness, the virus lies dormant in certain nerve tissue. As people age, it is possible for the virus to reappear in the form of shingles. Shingles is more common in people 50 years of age and older and in people who have weak immune systems. Up to 1 million cases of shingles occur each year in the United States.
A shingles rash usually appears on one side of the face or body and follows along the nerve root. The rash lasts from 2 to 4 weeks. The main symptom of shingles is pain, which can be quite severe and persist even after the rash is gone. Other symptoms include fever, headache, chills and upset stomach.
Treatment of shingles focuses on shortening the length of illness and pain relief. Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, are used to help shorten the length of illness. Pain medications, including topical medications, are used to help relieve the pain associated with shingles.
There is only one shingles vaccine. It is a live, attenuated vaccine.
Product: Zostavax® (Shingles)
Manufacturer: Merck & Co.
Year licensed: 2006
Although viral diseases can't be cured, doctors can prescribe oral antiviral medications, such as Zovirax® (acyclovir), Famvir® (famciclovir) and Valtrex® (valacyclovir), that help control the infection by hindering reproduction of the virus in the nerve cells. Antiviral drugs may also help prevent the painful after-effects of shingles known as postherpetic neuralgia or PHN. Other treatments for PHN include steroids, antidepressants, anticonvulsants, and topical agents.
To relieve pain, the doctor may recommend over-the-counter analgesics (pain-relieving drugs), such as ibuprofen and naproxen, or prescription drugs, such as indomethacin, all members of a class of medications known as nonsteroidal anti-inflammatory drugs. Acetaminophen is also commonly used to relieve the pain. If pain is severe, doctors may add stronger analgesics, such as codeine or oxycodone. If any of the blisters become infected it may take longer for the site to heal. Infections may be treated with antibiotics, in the form of a cream, or taken by mouth.
In the case of ophthalmic herpes zoster, treatment is likely to involve specific anti-viral eye drops, and possibly treatment by mouth as well. In the event of long-lasting pain (PHN), a pain specialist could be consulted.